Table 8.
Pharmacoeconomic analyses related to the use of lenalidomide maintenance therapy.
| Study | Analysis | Data source | Treatment | Findings |
|---|---|---|---|---|
| Jackson et al.98 | European (EU5) cost impact analysis | Cost-pathway model based on Myeloma XI dosing, real-world clinical prescribing, and expert clinical opinion | Lenalidomide maintenance (10 mg, assumed 50% received daily, 50% received d 1−21 in 28-d cycles; duration assumed per CALGB 100104 (Table 1)34) vs. no maintenance | Lower direct medical costs per patient over a 5-year period post ASCT (€209,600 vs. €276,900), attributed to a reduced requirement for subsequent lines of treatment |
| Connect® MM48 | Analysis of healthcare resource utilization | NDMM patients in Connect® MM who received induction and single ASCT | Lenalidomide-only maintenance (n = 180), any maintenance (n = 256), or no maintenance (n = 165), dosing not defined, for up to 2 years | No increased rates of healthcare resource utilization, including similar hospitalization rates, with lenalidomide compared with no maintenance. |
| Zhou et al.100 | Cost-effectiveness analysis, US payer perspective | Partitioned survival model based on data from CALGB 100104, pooled analysis of lenalidomide maintenance, and published literature | Lenalidomide maintenance (duration estimated per phase 3 meta-analysis (Table 1)32) vs. no maintenance and bortezomib maintenance (duration estimated from published literature) |
Life-years gained: 3.64 and 2.76 QALYs gained: 2.99 and 2.42 Incremental costs per life-year: $130,817 and $149,411 Incremental costs per QALY: $159,240 and $170,408 (WTP threshold: $200,000) |
| Uyl-de-Groot et al.99 | Cost-effectiveness analysis, Netherlands perspective | Partitioned survival model based on data from pooled meta-analysis of CALGB 100104, GIMEMA RV-MM-PI-209, and IFM 2005-02 studies; utility data from Connect® MM | Lenalidomide (10 mg, d 1–21, 28-d cycles; efficacy and safety from phase 3 meta-analysis (Table 1)32) vs. no maintenance |
Life-years gained: 2.79 QALYs gained: 2.26 Cost increase (first line): €147,707 Overall cost increase: €71,536 Deterministic ICER: €31,695 (WTP threshold: €50,000) |
ASCT autologous stem cell transplantation, ICER incremental cost-effectiveness ratio (cost/QALY), QALY quality-adjusted life-year, WTP willingness-to-pay.